i am confident that we will defeat germany to $4 trillion. 16 million people work in it. seven out of the 10 smartest kids in the high school graduating class work and our health care system somewhere. so when people in washington bravely talk about reforming the health care system, the degrees of difficulty or its magnitude, this is way harder than iraq. is like invading a country the size of germany, and i think that's a little bit what is happening now. the main feature of this health economy for most of the last five years has been disinflation. frankly, something no one, including the futurists predicted, in 2009 our health system arrived at a rate of increase in health spending that we haven't seen in this country since dwight eisenhower was president of the united states. five years before medicare, and we stayed at that level of maybe 3.8, 3.9% increase in spending for five long years. the economists who believe this was a product of the recession will have trouble explaining why per capita medicare spending has trended down towards zero during the same period of